The cancer burden is rising globally, exerting significant strain on populations and health systems at all income levels. In Kenya, cancer is the 3rd leading cause of death after infectious and cardiovascular diseases. The International Agency for Research in Cancer (IARC) GLOBOCAN report for 2018 estimated 47,887 new cases of cancer annually with a mortality of 32,987. This represents close to 45% increase in incidence compared to the previous report that estimated 37,000 new cancer cases annually with an annual mortality 28,500 in 2012.
Breast, cervix uteri, oesophagus, prostate and colorectum are the leading types of new cancer cases in both males and females across all ages, with oesophageal cancer being the leading cause of cancer deaths, followed by cervical cancer and then breast cancer. It is sad to note that 70-80% of cancer patients in Kenya are diagnosed at an advanced disease when it is not amenable to cure; this is part of the justification for developing these screening guidelines.
These National Cancer Screening Guidelines are in line with the implementation of the National Cancer Control Strategy 2017-2022 Pillar 1, which focuses on Prevention, Early Detection and Cancer Screening. It is also based on current evidence and international best practice and includes cancers recommended for screening by the World Health Organization, namely breast, cervical, colorectal, prostate, oral and childhood cancers. Early detection of oesophageal cancers has also been included in response to the related high mortality in Kenya.
The National Cancer Screening Guidelines have been developed through a multi-stakeholder consultative process involving national, county and civil society experts and reviewers and have an aspirational goal in line with Article 43 of the Constitution of Kenya, 2010, which confers on every person the right to the highest attainable standard of health. Their implementation will strengthen Kenya’s primary health care system and will contribute to the attainment of universal health coverage (UHC) ultimately culminating in the attainment of the President Uhuru Kenyatta’s Big Four Agenda.
The goal of screening is to isolate seemingly asymptomatic individuals in the community who have abnormalities that indicate that they could be having a pre-cancerous condition and link them promptly with the appropriate diagnosis, care and treatment. These National Cancer Screening Guidelines will help in reducing the preventable morbidity and mortality due to cancer by improving early detection and contributing to prompt and accurate treatment.
These guidelines are meant to standardize cancer screening, provide operational protocols and improve the outcome of cancer screening and treatment by streaming referral along the levels of care in Kenya. It is my appeal to all cancer stakeholders to work together to support the implementation of National Cancer Screening guidelines towards halting and reversing the increasing burden of cancer in Kenya.
Sicily K. Kariuki (Mrs), EGH
Cabinet Secretary
Ministry of Health